Laserfiche WebLink
10/11/2010 12:14:56 PM -0500 POWERED BY ORCAFAX PAGE 3 OF 3 <br /> • <br /> A ° CERTIFICATE OF -LIABILITY INSURANCE I DATE (M "DD""'" 10/11/2010 <br /> PRODUCER (386)446 -3426 FAX: (386) 446 -3514 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> as Coast Insurors Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR <br /> 4845 Belle Terre Pkwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Suite E <br /> Palm Coast FL 32164 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER A: Southern- Owners Insurance Co 10190 <br /> Kehle Plumbing Inc INSURER a Auto - Owners Insurance, Co 18988 <br /> P 0 Box 353511 INSURER C <br /> INSURER D <br /> Palm Coast FL 32135 INSURER E <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OISUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INER ADM - POLICY EFFECTIVE POLICY EXPIRM1ON <br /> LTR „teISRG 1VPP OF RELURANCP POUCY NUMBER OATS ISEWINDryyYY% DEW IIWIDDNYYyI UMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY PREMISES (Ea $ 300 , 000 <br /> A CLAMS MADE X OCCUR 78004427 10/20/2009 10/20/2010 MEDE)cP (Any one person) $ 10 , 000 <br /> PERSONAL 8, ADV INJURY $ 1, 000, 000 <br /> GENERAL AGGREGATE $ 2, 000, 000 <br /> GEML AGGREGATE UMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000, 000 <br /> POLICY EC T n LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LI MIT <br /> X ANY AUTO (Ea accident) $ <br /> — <br /> B ALL OWNED AUTOS 4779532700 10/20/2009 10/20/2010 BODILYINJURY <br /> SCHEDULED AUTOS (Per person) $ 1,000,000 <br /> H RED AUTOS <br /> BODILY INJURY <br /> NON-OWNED AUTOS (Per accident) $ 1,000,000 <br /> PROPERTY DAMAGE <br /> (Per accident) $ 1,000,000 <br /> GARAGE LIABILITY AUTO ONLY -EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ _ <br /> AUTO ONLY. AGG $ <br /> EXCESS/ UMBRELLA UABILITY EACH OCCURRENCE _ $ <br /> OCCUR 1 CLAIMS MADE AGGREGATE $ <br /> DEDUCTIBLE <br /> RETENTION $ $ <br /> WORKERS COMPENSATION YYC STATU- I0TM- <br /> AND EMPLOYERS' LIABILITY / N TORY LIMITS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ <br /> If es, describe under <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY UMIT $ <br /> OTHER <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> (813) 780 -0021 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> City of Zephyrhills DATE THEREOF, THE ISSUING INSURER WLL ENDEAVOR TO MAE. 10 DAYS WRITTEN <br /> 5335 8th Street <br /> Zephyrhills , FL 33542 NOTICE TO THE CERTIFICATE HOLDER SHALL <br /> TO THE LEFT, BUT FAILURE TO DO SO SHL <br /> OPPOSE NO OGLKGATION OR LLAWTY OF ANY NAND UPON THE INSURER ITS AGENTS OR <br /> REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIV E `t <br /> G Hicks, ACSR /MAGDAL • <br /> ACORD 25 (2009!01) ®1989 -2009 ACORD CORPORATION. All rights reserved. <br /> INS026 (200901) The ACORD name and logo are registered marks of ACORD <br />